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目的:探讨血清载脂蛋白E(ApoE)在不同病情HBV感染患者中的表达水平及其临床意义。方法:收集40例健康献血员以及57例慢性乙型病毒性肝炎(CHB)、55例乙肝肝硬化(LC)及50例原发性肝癌(HCC,HBSAg阳性)患者血清,检测载脂蛋白E(ApoE)、总胆固醇(TCHO)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)及肝功能指标,并对检测结果进行统计学分析。结果:疾病组(包括CHB、LC、HCC)血清ApoE含量均显著高于正常对照组(均P<0.05),随着疾病的进展ApoE含量逐渐升高,但组间差异不大(均P>0.05);而疾病组的其它血脂指标(TCHO、HDL-C、LDL-C、ApoA1、ApoB)均低于正常对照组。血清APOE与多个指标相关,特别是与γ-谷氨酰基转移酶(GGT)和亮氨酰氨基肽酶(LAP)的相关性较高(均r>0.30,均P<0.01)。高GGT值(大于100U/L)组血清APOE水平显著高于低GGT值(小于100U/L)组(t=-4.926,P=0.000)。高HBV载量(大于103IU/mL)组血清APOE水平显著高于低HBV载量(小于103IU/mL)组(t=-2.239,P=0.026)。结论:血清ApoE在不同病情HBV感染患者中的水平普遍升高,其表达可能受肝脏合成功能、淤胆因素以及HBV等多种因素的影响。
Objective: To investigate the expression and clinical significance of serum apolipoprotein E (ApoE) in patients with different HBV infection. Methods: The serum of 40 healthy blood donors, 57 CHB patients, 55 hepatitis B cirrhosis (LC) patients and 50 HCCAg positive patients were collected to detect the serum levels of apolipoprotein E (ApoE), total cholesterol (TCHO), HDL-C, LDL-C, ApoA1, ApoB and liver function Indicators, and test results for statistical analysis. Results: The levels of serum ApoE in the disease group (including CHB, LC, HCC) were significantly higher than those in the normal control group (all P <0.05). As the disease progressed, the content of ApoE increased gradually but the difference between groups was not significant (P> 0.05). However, other blood lipid indicators (TCHO, HDL-C, LDL-C, ApoA1, ApoB) in the disease group were lower than those in the normal control group. Serum APOE was correlated with multiple indicators, especially with γ-glutamyl transferase (GGT) and leucyl aminopeptidase (LAP) (all r> 0.30, all P <0.01). The serum APOE level of high GGT (> 100U / L) group was significantly higher than that of low GGT (less than 100U / L) group (t = -4.926, P = 0.000). The level of serum APOE in patients with high HBV load (more than 103 IU / mL) was significantly higher than those with low HBV load (less than 103 IU / mL) (t = -2.239, P = 0.026). Conclusion: Serum ApoE levels are generally elevated in HBV infected patients with different pathological conditions. The expression of ApoE may be affected by many factors, such as liver synthesis, cholestasis and HBV.